Late-onset posttransplant lymphoproliferative disease in a male kidney transplant patient on minimal triple immunosuppressive therapy: Diagnosis and management

Abstract

A 57-year-old male who had a successful live-related renal transplantation 14 years ago with stable graft function, on minimal triple immunosupression, presented with Burkholderia cepecia septicemia and graft dysfunction. He was successfully treated with parenteral imepenam. He was found to be Epstein–Barr virus Immunoglobulin G seropositive. Positron-emission tomography scan done showed metabolically active multiple cervical, mediastinal, axillary retroperitoneal, mesenteric, iliac, and inguinal lymphadenopathy. Further investigations revealed polymorphic posttransplant lymphoproliferative disease. His immunosuppressive therapy was tailored to lower cyclosporine dosage and discontinuation of azathioprine. His renal function improved. He was diagnosed to have a T-cell non-Hodgkin's lymphoma and subsequently succumbed to sepsis.

Keywords

• Burkholderia cepecia septicemia
• Epstein–Barr virus infection
• posttransplant lymphoproliferative disease
• T-cell non-Hodgkin's lymphoma